国际眼科纵览 ›› 2021, Vol. 45 ›› Issue (6): 477-482.doi: 10.3760/ cma.j.issn.1673-5803.2021.06.003

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T&E方案治疗糖尿病性黄斑水肿

尹立东 蒋博 张中宇 孙大卫   

  1. 哈尔滨医科大学附属第二医院眼科 150086
  • 收稿日期:2021-03-13 出版日期:2021-12-22 发布日期:2021-12-22
  • 通讯作者: 孙大卫,Email:drsundw@126.com

T&E regimen for diabetic macular edema

Yin Lidong, Jiang Bo, Zhang Zhongyu, Sun Dawei   

  1. Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China

  • Received:2021-03-13 Online:2021-12-22 Published:2021-12-22
  • Contact: Sun Dawei, Email: drsundw@126.com

摘要: 糖尿病性黄斑水肿(diabetic macular edema,DME)的临床一线治疗方法为玻璃体注射抗血管内皮生长因子药物。治疗并延长方案(treat and extend,T&E)是一种主动治疗方案,患者接受治疗至病灶稳定,在随访期间可根据疾病是否稳定来延长或缩短治疗间隔,该方案正逐步应用于DME。与现有常用的治疗方案相比,T&E方案降低每月固定方案注射次数及过度治疗的风险,同时避免每2个月方案治疗不足的可能;与按需治疗方案相比,可依据最佳矫正视力或中央视网膜厚度来调整随访间隔,通过规律地治疗提高视力并改善解剖结构。但目前T&E方案设计尚无统一标准,尚需更多的临床研究进一步规范。(国际眼科纵览,2021, 45:477-482)


关键词: 糖尿病性黄斑水肿, 治疗并延长方案, 抗血管内皮生长因子

Abstract: The first-line clinical treatment for diabetic macular edema (DME) is intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF). Treat and extend (T&E) is an active treatment regimen in which patients are treated until the lesion is stable and the interval of treatment can be extended or shortened during the follow-up period depending on whether the disease is stable. This regimen is being progressively used in the treatment of patients with DME. Compared with commonly used treatment regimens, the T&E regimen reduces the risk of fewer fixed injections per month and overtreatment while avoiding the possibility of undertreatment every two months. Follow-up intervals can be adjusted according to best-corrected visual acuity (BCVA) or central retinal thickness (CRT), and regular treatment can improve vision and anatomy as compared to on-demand treatment regimens. However, there is no unified standard for the design of T&E protocol in the current study, and more clinical studies are needed to further standardize it. (Int Rev Ophthalmol, 2021, 45: 477-482)

Key words: diabetic macular edema, treat and extend protocol, anti-vascular endothelial growth factor